Loss and grief amidst COVID-19: A path to adaptation and resilience.

The COVID-19 pandemic has posed an extreme threat to global health and become a leading cause of death worldwide. Loss, as a more encompassing theme, interweaves many aspects of people's life in this challenging time. Failure to address the pressing needs of those experiencing loss and grief may result in poor mental and physical health. Recognizing the uniqueness of each individual and their loss and grief will provide opportunities to develop tailored strategies that facilitate functional adaptation to loss and promote mental health and wellbeing in this crisis.

The role of mental health and protective factors in student academic persistence and retention during a global crisis.

The COVID-19 pandemic has exacerbated challenges for millions of students globally, leading to enrollment cliff. This study addresses the existing research gap by investigating the influence of students' mental health and various protective factors (i.e., optimism, help-seeking behaviors, social support) on academic persistence, an indicator of student retention. We utilized the structural equation modeling approach to examine the effect of students' mental health conditions, risk perception of COVID-19 and protective factors on academic persistence through a sample of 1,051 students from 45 states. Students' mental health positively predicted academic persistence. Risk perception of COVID-19 was negatively associated with mental health but positively predicted academic persistence and help-seeking behaviors. Optimism fully mediated the effect of mental health on help-seeking behaviors but did not mediate the effect of risk perception on help-seeking behaviors. Social support positively predicted academic persistence. This study underscores the integral role of mental health and protective factors in supporting student retention. Universities should develop targeted programs to address students' mental health needs and promote protective behaviors. These initiatives can enhance academic persistence, thereby aiding in the retention of students affected by this pandemic or any future global crisis.

The Moderating Role of Anxiety and Depressive Symptoms in Protective Effects of Health Behaviors among Clients Using Mental Health Services.

College-student clients using mental health services contend with increased anxiety and depressive symptoms, and their vulnerability to infectious respiratory diseases and severe clinical outcomes rises. To mitigate severe outcomes, health behaviors serve as essential protective tools to reduce the risk of infectious diseases, including COVID-19. Considering the escalating prevalence of anxiety and depression among college-student clients, little is known about how anxiety and depressive symptoms could potentially attenuate the protective effects of COVID-19 health behaviors (i.e., masking, social distancing, and hygiene practice). This study aims to examine the interactive effects of anxiety/depression and health behaviors in predicting COVID-19 infection. Methods: We analyzed data from the 2020-2021 Healthy Mind Study including a random sample of 9884 college-student clients in mental health services across 140 higher education institutions in the United States. We performed multivariable logistic regression to assess whether and to what extent the associations between COVID-19 health behaviors and infection depended on severity of anxiety or depressive symptoms. Results: Anxiety symptom severity negatively moderated the protective effects of social distancing against infection after adjusting for demographic characteristics and pre-existing chronic health conditions. Depressive symptom severity negatively moderated the protective effects of masking, social distancing, or hygiene practices against infection. Conclusion: The associations between certain COVID-19 health behaviors and infection were conditional on anxiety and depressive symptom severity. Findings suggest a potential public health benefit of mental health clinicians' efforts in assessing and treating clients' anxiety and depressive symptoms, namely reducing their vulnerability to COVID-19 infection and perhaps other infectious respiratory diseases.

Differential effectiveness of COVID-19 health behaviors: The role of mental health conditions in mask-wearing, social distancing, and hygiene practice.

Background: Mental health conditions are known to increase susceptibility to infectious diseases, including coronavirus disease 2019 (COVID-19). Health behaviors play a crucial role in mitigating this susceptibility. We aim to examine the differential effectiveness of COVID-19 preventive health behaviors among individuals, considering the presence or absence of specific mental health disorders. Methods: Multivariable logistic regression with interaction terms was performed to examine whether associations between adherence to health behaviors and COVID-19 infection were conditional on depression, anxiety, or eating disorders in a national sample of adults (N = 61,891) from 140 US universities, 2020-2021. Results: Adjusting for age, race/ethnicity, and gender/sex, the effectiveness of mask-wearing was significant and comparable among individuals with and without depression, anxiety, or eating disorders. Social distancing provided significantly less protection among individuals with depression, anxiety, or eating disorders. Hygiene practice provided significantly less protection among individuals with anxiety. Conclusion: Mask-wearing is robustly effective in the prevention of COVID-19 among individuals. However, social distancing and hygiene practice provide less significant protection among individuals with certain mental health conditions, suggesting the importance of prioritizing these individuals for additional preventive measures (e.g., vaccines targeting variants) and mitigation strategies (e.g., financial assistance, targeted mental health care, health education).

Responding to the HIV Health Literacy Needs of Clients in Substance Use Treatment: The Role of Universal PrEP Education in HIV Health and Prevention.

Health literacy, particularly HIV health literacy, is a key social determinant of health and can be significantly improved through targeted health education. This paper explores the often-overlooked potential of pre-exposure prophylaxis (PrEP) education as a powerful tool to enhance HIV health literacy among people with substance use disorders (PWSUD), a population notably susceptible to HIV. Given the syndemic interplay of substance use disorders (SUDs) and HIV, health professionals, especially substance use counselors, are uniquely positioned to bolster HIV health literacy and positively influence health outcomes. This article offers a brief introduction to PrEP, delineates potential barriers and facilitators to its use and education, and proposes strategies for effective PrEP education, implementation, and adherence. By equipping substance use counselors with essential knowledge and skills, we aim to encourage and promote the integration of PrEP education into substance use treatment. The overarching objective is to empower counselors to proactively engage in HIV prevention efforts, thereby fulfilling pressing health literacy needs and contributing to improved health outcomes among PWSUD.

Trends and prevalence of suicide 2017-2021 and its association with COVID-19: Interrupted time series analysis of a national sample of college students in the United States.

BACKGROUND: Suicide is among the leading causes of death for college students. We aimed to assess the impact of the pandemic on trends in suicidal thoughts and behaviors among college students, and whether suicidal thoughts and behaviors were associated with COVID-19 infection and psychosocial factors. METHODS: We analyzed 2017-2021 data from 4 waves of Healthy Minds Study including a random sample of college students (N = 354,473) from 286 U.S. institutions. We performed interrupted time series analysis to model the effect of the pandemic on trends in suicidal ideation (SI), plan (SP), and attempt (SA). At the peripandemic assessment, we utilized multivariable logistic regression to examine the association of SI, SP, and SA with COVID-19 infection and psychosocial factors. RESULTS: We observed significant decreases in SI, SP, and SA among college students from 2017 to 2021. The pandemic was significantly associated with a 1.33 percentage points reduction in SI and a 0.85 percentage points reduction in SP but was not associated with a significant reduction in SA. Adjusted associations of SI, SP, and SA with risk factors showed the significant odds ratio (OR) for suspected COVID-19 infection (SI: 1.33, SP: 1.22, SA: 1.32), severe depression (SI: 6.39, SP: 6.63, SA: 5.63), severe anxiety (SI: 3.66, SP: 3.62, SA: 3.60), COVID-19-related financial stress (SI: 1.35, SP: 1.34, SA: 1.48), food insecurity (SI: 2.12, SP: 2.13, SA: 2.79), and academic impairment (SI: 2.07, SP: 2.05, SA: 2.14) but not for test-confirmed COVID-19. CONCLUSION: Certain COVID-19 mitigation strategies might have protected college students from suicidal thoughts/behaviors.

Association between COVID-19 testing uptake and mental disorders among adults in US post-secondary education, 2020-2021.

SUMMARY: Fear and uncertainty have worsened mental health outcomes during the COVID-19 pandemic. COVID-19 testing is essential yet underutilised, and many people may experience difficulties accessing testing if the US federal government fails to sustain the testing capacity. To date, limited evidence exists about the role of COVID-19 testing in mental health. We examined the associations of COVID-19 testing uptake with certain mental disorders, through a nationally representative cohort of adults in US post-secondary education (N = 65 360). Adults with test-confirmed COVID-19 were at significantly lower risk than those with unconfirmed COVID-19 for severe depression, severe anxiety, eating disorders, and suicidal ideation. Findings suggest another potential benefit of public health efforts to encourage COVID-19 testing, namely promoting mental health.

Addressing collegiate mental health amid COVID-19 pandemic.

College students encounter unique challenges leading to poor mental health in the wake of the COVID-19 outbreak. Before the pandemic started, one in five college students experienced one or more diagnosable mental disorders worldwide. The fact that the COVID-19 pandemic affects collegiate mental health underscores the urgent need to understand these challenges and concerns in order to inform the development of courses of action and public health messaging that can better support college students in this crisis. This article provides recommendations that prepare higher education institutions and health professionals for addressing collegiate mental health needs and challenges posed by COVID-19.

Trends in Diagnosed Posttraumatic Stress Disorder and Acute Stress Disorder in US College Students, 2017-2022.

This cross-sectional study investigates trends in the prevalence of diagnosed posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) among US college students during a period of increased societal stresses and global health crises from 2017 to 2022.